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Outcome of combined transepithelial phototherapeutic keratectomy and accelerated corneal collagen cross-linking for progressive keratoconus

Poster Details

First Author: A.Dube INDIA

Co Author(s):    V. Kankariya   M. Grentzelos                 

Abstract Details


To study the effect and outcome of combined transepithelial phototherapeutic keratectomy (PTK) and accelerated corneal collagen crosslinking (CXL) treatment protocol in eyes with progressive keratoconus.


Asian Eye Hospital and Laser Institute, Pune, Maharashtra, India


This prospective interventional case series included 21 patients (30 eyes) with progressive keratoconus who underwent combined transepithelial PTK and accelerated CXL. The ultraviolet – A irradiation was performed for a duration of 10 minutes at the intended irradiance of 9 mW/cm2. The corrected distance visual acuity (CDVA), steep and flat keratometry (K) values, endothelial cell density (ECD) and demarcation line were evaluated preoperatively and 6 months postoperatively.


No intraoperative or postoperative complications were observed. The mean corneal stroma demarcation line one month postoperatively was noted at depth of 267.46 ± 35.37 µm. The mean CDVA improved from 0.36 ± 0.21 logMAR (logarithm of the minimum angle of resolution) preoperatively to 0.28 ± 0.18 logMAR postoperatively; however, this was not statistically significant (p = 0.16). None of the eyes lost lines of CDVA. The mean steep K readings decreased significantly from 51.38 ± 3.47 diopters (D) preoperatively to 49.24 ± 2.81 D postoperatively (p = 0.042). The mean flat K readings and ECD did not change significantly postoperatively.


The modified Cretan protocol using accelerated CXL treatment with transepithelial PTK was found to be effective and safe with no intraoperative or postoperative complications resulting in a favourable outcome.

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